The Recipe for Great Leaders There is scant literature about leadership in assisted living, but stud- ies involving nursing homes and long-term care in general suggest: • Servant leadership practiced by managers enabled them to engage the entire time to problem-solve and enable quality improvement.
• Passive-avoidant leadership styles are “excessively present” in long-term care, suggesting a need to invest in leadership development in this care sector.
• Relationship-oriented leadership contributes to higher job satisfaction and organizational commitment, as well as higher productivity.
• Leaders should focus on active leadership, especially task-ori- ented behaviors such as structure, coordination, and clarifying staff roles.
• Organizational performance is more closely connected to leadership experience than formal education. The variety of studies make it
Dave Creal
clear that leaders don’t fi t into one set mold or box, but they share various characteristics. These include, suggested Dave Creal, regional area director at Nebraska-based Hillcrest Health Services, critical/strategic think- ing skills, emotional intelligence, active listening and strong com- munication skills, innovative spirit, empathy, resilience, in- tegrity, honesty, self-confi dence,
self-motivation, self-discipline, vision, decision-making and problem-solving abilities, and a passion for their work. Some people possess some of these traits naturally. However, although they generally aren’t taught in schools, many such “soft skills” can be learned. As Creal noted, “When I entered health care, I didn’t have a lot of these skills. I wasn’t a strategic thinker, and my emotional intelligence wasn’t what it should be. I learned a lot of these skills from the people I worked with.” Today, he said, “Our company has a leadership training pro-
gram and put people through a leadership boot camp where they learn much of this. We also have Leadership 101 and 102 pro- grams that we put aspiring leaders through.” In some organizations, leaders
Collette Gray
are encouraged to help each other upskill and grow. Collette Gray, president/CEO of Integral Senior Living and Solstice Senior Living, said, “We always encour- age our leaders to share best practices and focus on providing avenues for our teams to do this easily. This creates a team of leaders who are all striving for
“Sometimes we learn by trial and error. The pandemic shone a light on how adaptable and agile leaders need to be. Those who weren’t able to adapt and adjust weren’t able to continue in their leadership roles.”
— Dave Creal
the same goals and helps build camaraderie and culture within our organization.” She added that leaders must understand how to build and
maintain a healthy, viable culture. “Building a culture within your organization that supports leadership development is critical and creating clear leadership paths that help formulate goals and opportunities for advancement,” Gray explained. It is essential, she said, to build an environment where leaders are empowered to make decisions in a timely and eff ective manner. “We provide the training to support this eff ort, and this was key to our success during COVID,” she observed.
The Uniqueness of Assisted Living Leaders While someone may lean toward one style or another, leaders in assisted living are a special breed. “We have to deal with creating a balance between maintaining a social model and caring for an increasingly medically complex resident population,” said Sarah Howd, MD, CMD, assistant professor of medicine and geriatrics at the University of Rochester, associate medical director of the Senior Living Practice at UR Medicine Geriatrics Group, and chair of AMDA—The Society for Post-Acute and Long-Term Care’s assisted living subcommittee. “I think the best leaders in this sector are those who are realistic
about what we can and can’t do and make decisions thoughtfully,” she said. “Leaders in assisted living need to promote clarity with staff , family, residents, and others.” Kevin O’Neil, MD, CMD, chief medical officer at ALG
Senior in Florida, noted, “As we transition to value-based care, it will be important for assisted living leaders to be part of the solution. We have to recognize that our residents have many health conditions; and while we can’t accommodate them all, we need to be conveners and bring services together to meet seniors’ health needs and avoid hospitalizations and ER visits.” One challenge for leaders in assisted living is that data isn’t
always consistent or extensive. “I am data-driven, but our business is a little more complicated because there sometimes is a lack
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